학술논문
Sinonasal complications associated with endoscopic orbital decompression
Document Type
Report
Source
Laryngoscope Investigative Otolaryngology. February 2021, Vol. 6 Issue 1, p71, 6 p.
Subject
Language
English
Abstract
INTRODUCTION Thyroid eye disease (TED) refers to group of autoimmune disorders affecting the eyes, often but not always in the presence of thyroid hormone level abnormalities, as found in Graves' [...]
: Objective: Characterize sinonasal complications associated with endoscopic orbital decompression for thyroid eye disease (TED). Methods: Retrospective analysis of patients who underwent endoscopic orbital decompression at Houston Methodist Hospital by two otolaryngologists and one ophthalmologist between May 2016 and February 2020 for TED. Patient ethnicity, age, laterality, operative approach (middle turbinectomy vs middle turbinate sparing), and history of prior sinusitis were collected. Results: One hundred and forty‐five orbital decompressions met the inclusion criteria. Postoperative obstructive sinusitis where herniated orbital fat caused obstruction of the sinus ostium occurred in 5.5% of operations. Patients who had a prior history of sinusitis were more likely to develop postoperative obstructive sinusitis (P =.02). The middle turbinectomy approach was more likely to show a reduced incidence of postoperative sinusitis (P =.014). Conclusion: Given the increased difficulty of managing sinonasal complications in the context of a decompressed orbit, efforts should be made to identify factors that might reduce the incidence of postoperative endonasal complications. The current study suggests that resection of the middle turbinate may allow for increased space for orbital fat herniation and lead to a decreased incidence of postoperative obstructive sinusitis. Level of Evidence: IV.
: Objective: Characterize sinonasal complications associated with endoscopic orbital decompression for thyroid eye disease (TED). Methods: Retrospective analysis of patients who underwent endoscopic orbital decompression at Houston Methodist Hospital by two otolaryngologists and one ophthalmologist between May 2016 and February 2020 for TED. Patient ethnicity, age, laterality, operative approach (middle turbinectomy vs middle turbinate sparing), and history of prior sinusitis were collected. Results: One hundred and forty‐five orbital decompressions met the inclusion criteria. Postoperative obstructive sinusitis where herniated orbital fat caused obstruction of the sinus ostium occurred in 5.5% of operations. Patients who had a prior history of sinusitis were more likely to develop postoperative obstructive sinusitis (P =.02). The middle turbinectomy approach was more likely to show a reduced incidence of postoperative sinusitis (P =.014). Conclusion: Given the increased difficulty of managing sinonasal complications in the context of a decompressed orbit, efforts should be made to identify factors that might reduce the incidence of postoperative endonasal complications. The current study suggests that resection of the middle turbinate may allow for increased space for orbital fat herniation and lead to a decreased incidence of postoperative obstructive sinusitis. Level of Evidence: IV.